Jan. 11, 2011

Before becoming a medical student, even before applying to medical school, from the very first moment you proclaim “I want to be a doctor,” you hear the same question repeatedly. What kind of doctor do you want to be?

The simplest answer would be, “A good one. A kind one.” You might get a chuckle and perhaps some relief from prying minds, at least temporarily. But that question will quietly nag you through your long and difficult journey until it is finally decided.

“How did you decide?” I am often asked. It was quite by accident that I stumbled on this small specialty, otolaryngology—ear, nose, and throat (ENT). The story goes: I had just finished my surgical rotation and had only 6 weeks of psychiatry and 6 weeks of vacation to complete the year. My fourth year elective schedule was due in student affairs the next day.

I ran into a fourth year student I knew who was getting ready to graduate. I asked him what he was going to do and he told me about ENT. Sounded interesting. I'd see all ages of patient, practice both medicine and surgery. An ENT's expertise ranges from microsurgery on the ear, to plastic surgery on the face, to removal and reconstruction of complicated head and neck cancers. Mysterious in a way.

I signed up for this usually popular elective during my “vacation block” when there were no longer any fourth year students and only 18 other students "on vacation" during that rotation. None of the other students wanted this elective so I had two great professors all to myself—Dr. Frank Marlowe and Dr. Robert Wolfson—both of whom loved to teach, not only about the patients, but also about the specialty and its history. After only 3 days, their love of this quirky specialty was completely transferred to and embedded in me.

What was it that ultimately made me decide to become an ENT specialist? Was it the 80 year old woman who came to us because she couldn’t hear? She exclaimed, “Thank you! I can hear again,” as Dr. Marlowe removed of the large wax balls from her ear canals. So simple a treatment (or so it seemed,) yet so impactful. Or maybe it was the 45 year old man who was having an operation to fix his hearing. He couldn’t hear because the smallest bone in the body, the stapes, was “fixed” instead of “mobile” and therefore it wasn't able to transfer the sound to the inner ear. The immovable bone was replaced with an operation called a stapedectomy. As the ear bone prosthesis was placed and the ear drum put back into place, the patient exclaimed, “Thanks, doc, I can hear again.” I was amazed. It was like magic. Dr. Wolfson pulled off his gloves and the operation was over. I was hooked.